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Human Immunodeficiency Virus (HIV) ProphylaxisEarly Phase 1NCT02431273

Safety and Pharmacokinetic Study of HIV Prophylaxis Using Antiretroviral Intravaginal Rings in Healthy Women

A Early Phase 1 study testing TDF IVR, TDF-FTC IVR and TDF-FTC-MVC IVR in people with Human Immunodeficiency Virus (HIV) Prophylaxis, run by Auritec Pharmaceuticals at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study will evaluate the hypothesis that intravaginal rings (IVRs) can safely and in a sustained fashion, deliver the antiretroviral (ARV) drugs - tenofovir disoproxil fumarate (TDF), emtricitabine (FTC), and maraviroc (MVC), in healthy women when used in the following drug combinations: 1) TDF ("Single" IVR); 2)… Read more about this study

Who is it for?
Ages 18 to 45 years, women onlyHealthy volunteers can take part
What is being tested?
TDF IVR, TDF-FTC IVR and TDF-FTC-MVC IVR
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
1 siteUnited States
Study dates
Jun 2015to Dec 2016
Phase
Early Phase 1
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 45 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Provides written informed consent
  • Healthy female 18-45 years of age
  • HIV negative per subject report and results of screening examination
  • Negative for sexually transmitted diseases in the past 3 months and at screening exam
  • No history of genital herpes simplex I or II per subject report
  • Currently using contraception with plans to continue throughout the study duration or having sex with females only
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  • Pre-menopausal with a regular menstrual cycle with at least 21 days between menses and no history of intermenstrual bleeding or with suppressed menstrual cycle by hormonal contraception such as Depo-Provera or continuous oral contraceptive agents
  • Subjects must agree to abstain from vaginal, anal, and oral sex throughout the first week of each dosing period and then use condoms for vaginal/rectal intercourse until after the final visit for use of each IVR
  • Subjects must agree to not douche or use any vaginal product other than the Single, Dual and Triple ARV IVRs, including lubricants, feminine hygiene products, and vaginal drying agents throughout the dosing period and until after the final visit
  • Subjects must agree to blood draws and vaginal exams throughout the course of the study

Who cannot join

  • HIV positive by subject report or results of screening examination
  • Positive history for autoimmune disease
  • Abnormal genital exam defined as grade 1 or higher adverse event by DAIDS genital AE grading table
  • Abnormal ALT or AST or Hepatitis B infection
  • Active vaginal infection as determined by site IoR
  • Abnormal renal function (defined as a creatinine clearance of <50mL/min/1.73 m2)
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  • Pregnant or less than 6 months post-partum or current lactation
  • Current use of an IVR (i.e., Nuvaring, Estring, Femring)
  • History of TDF, FTC, and MVC use and/or adverse reaction to any of these drugs
  • History of adverse reaction to silicone
  • History of toxic shock syndrome
  • Currently receiving chemotherapy or immunosuppressive agents
  • Use of investigative drugs within 30 days or 5 half-lives
  • Currently using or suspected to be using non-therapeutic injection drugs

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Texas Medical Branch

    Galveston, Texas, 77555-0587

Other trials in United States

About this study

Official title: Open-Label Safety and Pharmacokinetic Study of Single (TDF), Dual (TDF-FTC), and Triple ARV IVR (TDF-FTC-MVC) in Healthy Women

This study will evaluate the hypothesis that intravaginal rings (IVRs) can safely and in a sustained fashion, deliver the antiretroviral (ARV) drugs - tenofovir disoproxil fumarate (TDF), emtricitabine (FTC), and maraviroc (MVC), in healthy women when used in the following drug combinations: 1) TDF ("Single" IVR); 2) TDF-FTC ("Dual" IVR) and; 3) TDF-FTC-MVC ("Triple" IVR).

TDF = tenofovir disoproxil fumarate; FTC = emtrcitabine; MVC = maraviroc

Read the detailed description

The broad long term goal of this project is to empower women to protect themselves from HIV through woman-controlled sustained local delivery of ARTs via intravaginal rings. The short-term general investigational plan is to evaluate IVRs releasing TDF, TDF-FTC and TDF-FTC-MVC in healthy women for up to 7 days in an open-label study to determine safety and drug concentrations in plasma and cervicovaginal lavage and secretions. Additional exploratory studies will be considered and planned based in part on the results obtained in this study. The long-term investigational plan is to evaluate the safety and efficacy of sustained release TDF, TDF-FTC and TDF-FTC-MVC for their ability to decrease HIV transmission to vulnerable women.

Being tested
TDF IVR, TDF-FTC IVR, TDF-FTC-MVC IVR
Keywords
TDF, FTC, MVC, TDF-FTC, TDF-FTC-MVC, IVR, ARV
Medical subject headings
Acquired Immunodeficiency Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TDF IVRDrug

    Also called Single IVR

  • TDF-FTC IVRDrug

    Also called Dual IVR

  • TDF-FTC-MVC IVRDrug

    Also called Triple IVR

Study groups in NCT02431273
Study groupRoleWhat they receive
TDF (Single IVR)ExperimentalAll subjects will be asked to wear "Single" (TDF) IVRs for 7 days.
Receives: Drug: TDF IVR
TDF-FTC (Dual IVR)ExperimentalIf the TDF IVR is determined as safe, study participants will be asked to replace it with "Dual" (TDF-FTC) IVRs for 7 days. There will be follow-up visit between removal of a single IVR and replacing it with a dual IVR.
Receives: Drug: TDF-FTC IVR
TDF-FTC-MVC (Triple IVR)ExperimentalIf the TDF-FTC IVR is determined as safe, study participants will be asked to replace them with "Triple" (TDF-FTC-MVC) IVRs for 7 days. There will be follow-up visit between removal of a dual IVR and replacing it with a triple IVR.
Receives: Drug: TDF-FTC-MVC IVR

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Specific Graded Adverse Events in Single, Dual, and Triple Antiretroviral (ARV) Intravaginal Rings (IVRs)

    Number of Adverse Events (AEs) was recorded. Safety parameters were monitored for each IVR combination and the grading scale for each parameter followed the Female Genital Grading Table for Use in Microbicide Studies. AEs not included in that table were graded using the Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Version 2.0, November 2014 (Grade 1 = mild, Grade 2 = Moderate, Grade 3 = Severe, Grade 4 = Potentially Life-Threatening).

    Measured: Days 0-21 following insertion of each IVR.

  2. Pharmacokinetics of the Single, Dual and Triple ARV IVRs: Cervicovaginal Fluid (CVF)

    Drug concentrations [tenofovir (TFV), tenofovir disoproxil fumarate (TDF), emtricitabine (FTC) and maraviroc (MVC)] in cervicovaginal fluids (CVF) for each IVR combination.

    Measured: Time points at which outcome measure was assessed are Days 2 (after IVR insertion) and 7 (day of IVR removal).

  3. Pharmacokinetics of the Single, Dual and Triple ARV IVRs: Cervicovaginal Lavage (CVL)

    Drug concentrations [tenofovir disoproxil fumarate (TDF), emtricitabine (FTC) and maraviroc (MVC)] in cervicovaginal lavage (CVL) were evaluated for each IVR combination.

    Measured: Time points at which outcome measure was assessed are Days 2 (after IVR insertion) and 7 (day of IVR removal).

  4. Pharmacokinetics of the Single, Dual and Triple ARV IVRs: Vaginal Tissue

    Drug concentrations [tenofovir disoproxil fumarate (TDF), tenofovir (TFV), tenofovir diphosphate (TFV-DP), emtricitabine (FTC) and maraviroc (MVC)] in vaginal tissue (VT) were evaluated for each IVR combination.

    Measured: Time points at which outcome measure was assessed are Days 2 (after IVR insertion) and 7 (day of IVR removal).

  5. Pharmacokinetics of the Single, Dual and Triple ARV IVRs: Plasma

    Drug concentrations [tenofovir disoproxil fumarate (TDF), emtricitabine (FTC) and maraviroc (MVC)] in plasma were evaluated for each IVR combination.

    Measured: Time points at which outcome measure was assessed are Days 2 (after IVR insertion) and 7 (day of IVR removal).

  6. Pharmacokinetics of the Single, Dual and Triple ARV IVRs: Terminal Half-life

    Drug concentrations [tenofovir disoproxil fumarate (TDF), emtricitabine (FTC) and maraviroc (MVC)] in terminal half-life were evaluated for each IVR combination.

    Measured: Time points at which outcome measure was assessed are Day 7 (day of IVR removal) and daily up to 14 days.

Secondary outcomes (1)
  1. Acceptability of the IVRs

    Acceptability of the IVRs was assessed through reported willingness to use the IVR for 28 days in a real-world setting on a likert scale, 1 being "not at all confident" to 5 being "completely confident" for Periods 1 and 2.

    Measured: Days 0-21 following insertion of each IVR.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 May 2015 (estimated)
  2. Study startJun 2015
  3. Primary completionDec 2016
  4. Study completionDec 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Early Phase 1
Primary purpose
Prevention
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
10 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02431273
Sponsor's protocol ID
ARV-IVR 01
Other IDs
2R44HD075636-02
Status last verified
Jun 2019
First submitted
4 Aug 2014
Last updated
2 Jul 2019
Data monitoring committee
No

Publications

  • Vincent KL, Moss JA, Marzinke MA, Hendrix CW, Anton PA, Pyles RB, Guthrie KM, Dawson L, Olive TJ, Butkyavichene I, Churchman SA, Cortez JM Jr, Fanter R, Gunawardana M, Miller CS, Yang F, Rosen RK, Vargas SE, Baum MM. Safety and pharmacokinetics of single, dual, and triple antiretroviral drug formulations delivered by pod-intravaginal rings designed for HIV-1 prevention: A Phase I trial. PLoS Med. 2018 Sep 28;15(9):e1002655. doi: 10.1371/journal.pmed.1002655. eCollection 2018 Sep.

    PubMed 30265679
  • Moss JA, Butkyavichene I, Churchman SA, Gunawardana M, Fanter R, Miller CS, Yang F, Easley JT, Marzinke MA, Hendrix CW, Smith TJ, Baum MM. Combination Pod-Intravaginal Ring Delivers Antiretroviral Agents for HIV Prophylaxis: Pharmacokinetic Evaluation in an Ovine Model. Antimicrob Agents Chemother. 2016 May 23;60(6):3759-66. doi: 10.1128/AAC.00391-16. Print 2016 Jun.

    PubMed 27067321

Questions about this trial

What is this clinical trial studying?

A Early Phase 1 study testing TDF IVR, TDF-FTC IVR and TDF-FTC-MVC IVR in people with Human Immunodeficiency Virus (HIV) Prophylaxis, run by Auritec Pharmaceuticals at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 2 Jul 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Early Phase 1 (sometimes called Phase 0) studies give a very small amount of a treatment to a few people, mainly to see how the body handles it.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 2 Jul 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Specific Graded Adverse Events in Single, Dual, and Triple Antiretroviral (ARV) Intravaginal Rings (IVRs) (time frame: Days 0-21 following insertion of each IVR.). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02431273, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jul 2019.

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